Provider Demographics
NPI:1679067128
Name:RHODE, JENNIFER JEAN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JEAN
Last Name:RHODE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JEAN
Other - Last Name:CATOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:484 CEDARWOOD TER
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-7135
Mailing Address - Country:US
Mailing Address - Phone:585-738-9311
Mailing Address - Fax:
Practice Address - Street 1:6 PUPPY LANE
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:NY
Practice Address - Zip Code:14487
Practice Address - Country:US
Practice Address - Phone:585-346-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027721235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist